Effie Gray was the young wife of art critic John Ruskin. He whisked her away from her impoverished Scottish family to a life among the artistic elite of London, where he proceeded to ignore her completely. ‘Ignoring’ doesn’t cover it, really. Ruskin was so deeply entwined in his parents’ apron strings, and so obsessed with his work routines, that he neglected and shunned Effie. He was disgusted by her physicality (in fact he never came anywhere near her body), and incapable of intimacy. She was completely isolated in a hostile household and cut off from any friendships. She could not complain to anyone because he was acting within his rights. She had married him now, and there was nothing to be done without disgracing herself.

I learnt her story recently from the film ‘Effie Gray’ (2014). The film shows Effie bearing up with optimism initially, trying different ways to form a relationship with her emotionally stunted husband. Yet as her situation becomes more and more oppressive, she starts having headaches and nightmares, her hair falls out in patches, she feels desperate and turns to laudanum. There was no strategy she could employ that would not bring all the blame back on herself, so illness was her ‘least worst’ option.

Before you get worried, I am not trying to draw any parallels between the circumstances of Effie’s life and that of 21st century young people! What did make me sit up, though, was the moment when the doctor comes to examine her. Ruskin recites her litany of symptoms, and the kind doctor sees exactly how things are in the household. But being a Victorian doctor, he concludes that 'It is clearly a nervous complaint.’ Well, of course I screamed (I do this kind of thing): ‘NO! It is her cry of frustration and rage! Let her speak and LISTEN to her!’ The doctor, instead, prescribes rest and fresh air, and more gentle treatment.

‘How glad I am that we don’t medicalise people’s reasonable responses to impossible situations these days,’ I thought - then immediately thought about diagnostic labels applied to young people such as ‘Emotionally Based School Refusal’. Of course, there are many mental health conditions whose origins are primarily physiological and/or inherited – and in this area, good progress is being made in both treatment and societal acceptance. But what about the widespread, often low-level mental distress that seems to be creeping across so much of the young population?

True, we don’t talk about ‘hysteria’ and ‘nervous complaints’ any more, but in treating this distress as a pathological response, aren’t we doing exactly the same thing? Critical psychologist Mary Boyle (2011) points out that we have got into the habit of talking about depression and anxiety as ‘causes’ of distress instead of as what they often are, consequences of events and situations. Perhaps throughout history, illness has been we have interpreted the resistance of the powerless as illness. If you can’t function in this society, or you refuse to because you see it as unjust, you must be ill. ​But the flipside of it is that illness can be an effective tool of resistance. It is a way of refusing to play the part one has been assigned in a system. And illness can claim its own articulate voice. Just before Effie gathers her strength to leave Ruskin (it’s brilliant how she does it, I won’t spoil it), she makes a gesture that is almost explosive in that silent house: she does up her hair so as to show off her alopecia bald patches to best effect. She does not need to explain that she is forcing her husband and parents-in-law to gaze upon the impacts of their actions, that she has ceased to comply, that they can expect further unexpected surprises, that the future will be at least partly of her making.